Productive outrage: An essential leadership quality to create health equity

At the beginning of my career, I was a newly minted CEO of a struggling hospital in the U.S. Virgin Islands when a young man arrived in the emergency department with a severe gunshot wound. To survive, he needed a blood transfusion – fast. But we were at the mercy of island blood banks; the local government prohibited hospitals from managing their own procurement. The bank refused to send additional blood because the hospital had an unpaid bill. I knew the clock was ticking and called the territorial finance administrator. After navigating mind-boggling, unnecessary red tape, we got the blood needed to save that young man’s life. While he made a full recovery, his care and healing were jeopardized because of bureaucratic and financial messes that had absolutely nothing to do with him.

As a young administrator, I naively believed this was a relatively isolated instance of a system failing someone - an exception, not the rule. But in my 30 years of healthcare leadership, I have seen firsthand that systems running on autopilot can fail people without direct leadership intervention. And when systems repeatedly fail the same groups of people over and over, they fuel a sense of outrage and institutionalized injustice. Viewed through this lens, that patient nearly dying wasn’t an isolated incident at all.

In fact, it’s one that far too many Americans can identify with. It relates to my own experience growing up in Philadelphia. From a young age, I felt outraged and powerless as I watched news stories about people who looked like me getting arrested or shot because of the color of their skin. Broken systems, avoidable tragedies, outrage – it’s an all-too-familiar familiar cycle.

Today’s health care realities continue to fuel that outrage. Consider: A Black woman is three to four times more likely to die from pregnancy complications than a white woman. A Latino man is more likely to be diagnosed with colorectal cancer at later stages than a white man. A Native American teen is 50 percent more likely to commit suicide than the majority population. And, just recently, The Journal of the American Medical Association published research showing that 74,000 African Americans die annually because of pervasive health disparities.

I am outraged by these statistics… but?what I’ve come to realize as a leader is that being outraged when dealing with human suffering and inequities is necessary but insufficient. On one hand, losing one’s sense of outrage is the breeding ground for complacency, disengagement and silence. Productive outrage, however, is fundamentally different. It is about using?the emotion of outrage?as fuel to disrupt inequities at their root cause by developing sophisticated approaches to address systemic issues. And it is about the hardest work you will do.?

At Advocate Health, a?health system that employs 150,000 teammates and provides care to more than 6 million people across the Southeast and Midwest, we are doing just that.?We’re building a national center for health equity to disrupt the root causes of disparities, creating the largest health equity data repository in the country and rewiring all of our care models to ensure we’re delivering on health equity. We’re bringing mobile primary care units to neighborhoods in need. We’re leading the way on expanding access to affordable housing and fueling economic mobility. And we’re ensuring our teams and leadership reflect the communities we serve.

This work is demanding, and progress never feels fast enough because we continue to see far too many examples where – just as with the gunshot victim above?– the system feels stacked against those in greatest need.?But we persevere day in and day out because we know people are counting on us with their very lives.??

And while it can feel overwhelming to know where to even begin, the thousand-step journey toward true equity begins with the first steps. Fundamentally, it starts with each of us asking ourselves honest and uncomfortable questions.

1. What are you doing within your sphere of influence to make the communities you serve more equitable?
2. Have your actions truly improved lives in tangible ways?
3. And how do you really know??

It is in your answers to questions such as these that you?can begin to channel outrage to productive purpose... to create a better future?for all.?Perhaps Socrates put it best when he said:

"The secret of change is to focus all of your energy not on fighting the old, but on building the new."

*This piece was originally published in Becker's Healthcare : Productive outrage: An essential leadership quality to create health equity (beckershospitalreview.com)